09-08-2007, 12:55 PM
An obese 33-year-old woman has had four 12-hour
episodes of
severe, sharp, penetrating pain in the right upper
quadrant of the abdomen
associated with vomiting but no fever. She has no
diarrhea, dysuria, or
jaundice and is asymptomatic between episodes. There
is slight
tenderness to deep palpation in the right upper
quadrant. Which of the
following is the most appropriate next step in
diagnosis?
A
) Supine and erect x-ray films of the abdomen
B
) Upper gastrointestinal series
C
) Ultrasonography of the upper abdomen
D
) CT scan of the abdomen
E
) HIDA scan of the biliary tract
episodes of
severe, sharp, penetrating pain in the right upper
quadrant of the abdomen
associated with vomiting but no fever. She has no
diarrhea, dysuria, or
jaundice and is asymptomatic between episodes. There
is slight
tenderness to deep palpation in the right upper
quadrant. Which of the
following is the most appropriate next step in
diagnosis?
A
) Supine and erect x-ray films of the abdomen
B
) Upper gastrointestinal series
C
) Ultrasonography of the upper abdomen
D
) CT scan of the abdomen
E
) HIDA scan of the biliary tract